DEAR DOCTOR K:
I have trouble falling asleep and melatonin has not worked. I want to avoid medications, and I have read that magnesium supplements can help. Should I try them?
Magnesium is important for many biological functions, including nerve and muscle function. It may have a role as a preventive treatment for migraine headaches. But there is not strong scientific evidence for its use with insomnia.
The studies that have suggested a sleep benefit have been small (fewer than 50 participants) and short (eight weeks). Small benefits in sleep quality were observed in subjects who were elderly. One study was of nursing home residents. With such limited evidence, it is difficult to strongly support regular use of magnesium for insomnia.
Is there a reason to think you lack magnesium? Since most of the magnesium in the body is inside cells and bones, blood levels of the mineral do not tell the whole story. Magnesium deficiency is common in hospitalized individuals. That’s particularly true for patients in intensive care units. But it is unusual in healthy people.
You may be at increased risk of low magnesium if you take certain medications. Some diuretic medicines, used to get rid of excess fluid and to lower blood pressure, increase magnesium loss in the urine. Long-term use of proton-pump inhibitors for acid reflux can interfere with magnesium absorption. In most other people, dietary magnesium should be sufficient. Your kidneys control how much magnesium is eliminated in your urine. When your blood levels of magnesium are low, your kidneys keep magnesium in the blood and out of the urine.
If you’d like to increase your dietary magnesium intake, focus on eating more green leafy vegetables, nuts and seeds. These foods are part of a healthy diet and also associated with a reduced risk of heart disease.
The following “sleep hygiene” habits will also help you get some shuteye:
- Stay away from stimulants. Avoid caffeinated beverages after early afternoon. Avoid alcoholic “nightcaps,” as alcohol also is a stimulant. At first, it may help you to nod off. But several hours after your last drink, the alcohol starts stimulating the brain, keeping you from deep sleep.
- Don’t nap if you can avoid it. If you can’t stay awake, limit yourself to a 15- to 20-minute afternoon nap.
- Exercise regularly, but not within a few hours before bedtime. Exercise stimulates the brain and makes it harder to fall asleep promptly.
- Set a sleep schedule. Try to go to bed and wake up at the same time every day, shooting for seven to nine hours of sleep.
- Make your bedroom a sleep sanctuary. Reserve it for sleep, intimacy, and restful activities such as meditation and reading for pleasure. Keep it cool, dark and quiet.
- Don’t watch the clock. Watching the sleepless minutes pass makes it harder to fall back to sleep.
- Establish a relaxing routine before bedtime. Meditate, take a warm shower or listen to quiet music.